Student-Level Data Request Form
Contact Information
Primary contact name:
Email:
Phone number:
Organization:
Job title (if applicable):
Mailing address:
Secondary contact name:
Email:
Phone number:
Organization:
Job title (if applicable):
Mailing address:
Student-Level Data Request Form
1
Purpose, Scope, and Duration
1) Provide a detailed description of the study. Completely describe the purpose and scope of
the project. Include the types of analyses to be conducted or statistics that will be generated,
using which data fields.
Use of the data received under the Memorandum of Understanding is limited to the purpose
and scope defined.
2) How will this project benefit education in Washington?
3) Describe how the results will be used. What are the expected products of this research?
(reports, evaluation, analysis tools, etc.). How will the results be shared?
As part of the MOU, Requestor will agree to share any products or reports to OSPI before they
are released, published or otherwise made available. OSPI does not approve findings, reports,
or products, but will keep this information with the MOU to confirm the data use was
consistent with the approved request.
4) Proposed start date:
Proposed end date:
Requests will be approved for a maximum of three years. If request is for three years please
provide justification.
Student-Level Data Request Form
2
Data Security / Technical Requirements
1) Describe in detail where the data will be stored and the security on your computing
systems. How will you prevent others (who are not named in the data-sharing agreement
and have not signed the non-disclosure forms) from accessing the data and computer where
the data will be stored? Provide a copy of your data security policies and procedures.
2) Using student-level data files requires the ability to handle large amounts of data. What
software will be used to store, access, and analyze the data?
3) List everyone who will have access to the data, their involvement in the project, and
justification for having access to the data.
Everyone with access to the data must sign the non-disclosure form.
4) Describe the method(s) that will be used to destroy the student data at the expiration or
termination of the agreement.
Student-Level Data Request Form
3
Requested Data
Check the cells below associated with the data file and year being requested. This information
should align with the project description above.
Previous
years
(specify)
2011-12
2012-13
2013-14
2014-15
Future
years
(specify
last)
CEDARS
Student enrollment
Student programs
Student schedule
Staff schedule
Student grade history
Student absence
Student discipline
ASSESSMENT
MSP / HSPE
Smarter Balanced
Math EOC
Biology EOC
WaKIDS
Other
For assessment data, most researchers are interested in proficiency level and scale scores. If your
research requires other assessment detail, please describe what is being requested and how it fits
into the proposed research.
 Additional assessment information:
Indicate your preferred data file type: CSV, tab-delimited, or SPSS.
Student-Level Data Request Form
4
De-identification
For education research datasets, OSPI uses an aggressive approach to de-identification that still
yields research or evaluation value. If your proposed project requires a less aggressive deidentification methodology, you will need to provide additional research justification for the
inclusion of certain information or files.
Fill out the table below based on your research needs for data. If you mark any of the boxes in
columns (b) or (c) to indicate that you need additional data detail, provide a complete research
justification for each. Describe how it will be used in your analyses, why it is necessary to achieve
the project outcomes, and how information from those fields will (or will not) be incorporated into
your final products.
A
Data
Default
Ethnicity / race*
 Roll up of 7
categories.
Corresponds to
federal reporting.
[most common]
 State level
School / district
codes**
Student grade history
 Not requested
Student discipline
Student programs or
other detail
 Not requested
 Not requested
Student-Level Data Request Form
B
C
Greater Detail 1
Greater Detail 2
(requires research
(requires research
justification)
justification)
 7 categories listed  Full detail and all
separately (student
categories
may be in multiple
categories)
 School and district
codes for nonsmall districts
(Districts with
< 100 students
would be coded as
“small district”)
 Course enrollment
information from
grade history file
 Discipline file
Y/N Flags for:
 Bilingual
 Special education
 Migrant
 FRPL
 Other (please list):
________________
________________
________________
________________
 All school and
district codes,
regardless of size
 Full grade history
file (including
credits earned and
grades)
 Special
Education
program detail
 Disability code
5
* Ethnicity / race:
(a) Federal Ethnicity / Race roll-up. Each student is marked as one and only one category. If
Hispanic ethnicity is reported, then the student is coded as Hispanic. If not, the other race
category is reflected. If multiple race categories are marked, the student is “2 or more
races”.
 Asian, American Indian, Black, Hispanic, Hawaiian/Pacific Islander, White, 2+
(b) Hispanic/Non-Hispanic reported as a separate element, plus the other race categories
reported separately. (e.g. a Black, Native American, and Hispanic student would show in
each category rather than just being reported as Hispanic. Or an Asian/White student
would show in both categories rather than the 2 or more category)
(c) Full detail. Shows full detail and all categories. A single student could be reported as
Hispanic (Cuban), White, Korean, and Tulalip.
* School / district codes
(a) State-level reporting. Allows for statewide analyses; school and district codes not included.
(b) School and district codes included for non-small districts. In other words, this option
identifies associated schools and districts for students who are enrolled in districts of at
least 100 students. Codes for small districts would be suppressed. The student data for
small districts would be included, but students would be associated with a generic “Small
District” code rather than a specific one.
(c) School and district codes included for all districts, regardless of size.
Student-Level Data Request Form
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